East York health team says the electronic records make the care they provide safer and more personal.

At an East York medical centre, Dr. Marcus Law doesn't carry a clipboard or medical file into an examination room when he sees a patient.

In fact, paper medical records for the 10,000 patients of the South East Toronto Family Health Team are stored in dusty bankers' boxes in the basement of the facility.

When Law, the team's lead physician, sees patients he calls up their records on one of 50 desktop computers at the centre. In Ontario, where the switch to electronic medical records has been painstakingly slow, most recently hobbled by the eHealth scandal, this clinic stands out as an exception.

The most pertinent parts of old patient files have been scanned onto electronic medical records. Law says that, without a doubt, reliance on electronic records rather than bulky paper files translates into better and more efficient patient care.

"It allows us to practise more patient-centred care. Instead of waiting for the patient to come to me, I'm offering more proactive treatment," he says, explaining, for example, that there is less of an onus on patients to know what tests they need.

Though the benefits are obvious, the province's health system has been woefully slow to adopt new technology, the Ontario Health Quality Council said earlier this year. Approximately 25 per cent of the province's family physicians use electronic medical records, compared with 50 per cent in Alberta and 98 per cent in the Netherlands.

In Ontario, the effort has been stymied by what has become known as the "billion-dollar boondoggle," a spending controversy involving high-priced consultants and untendered contracts.

Indeed, the controversy turned eHealth Ontario, the organization charged with managing the switchover, on its head with the resignations earlier this year of Health Minister David Caplan, deputy minister Ron Sapsford, eHealth board chair Alan Hudson and CEO Sarah Kramer.

The scandal will further delay reaching the provincial goal of having electronic medical records for every Ontarian.

The initial target of 2015 is now up in the air, concedes Rob Devitt, interim chair of eHealth. Devitt is president of Toronto East General Hospital and has been brought in by the province until the end of the year to get eHealth back on the rails.

"We are recalibrating our timelines," he says when asked about a new deadline.

Currently, about 4 million of more than 12 million Ontarians have electronic health records with their primary health care providers. Those 4 million are arguably in the most progressive and modern practices in the province.

The South East Toronto Family Health Team is a multidisciplinary practice that includes in its ranks 12 doctors, two nurse practitioners, four registered nurses, one addictions counsellor, three social workers, three dietitians, one chiropodist, one care navigator and 15 medical residents.

When signing up to such a practice, patients are asked for written consent to allow other members of the family health team to have access to their records.

"No one outside the four walls can see the records," Law says, explaining that patient confidentiality is assured.

In explaining the benefits, he offers up the example of a patient who comes to see him with a sprained ankle. When Law calls up the individual's file, he gets an alert telling him this patient is due for a screening procedure such as a colonoscopy.

Law recently used the system to pull up a list of some 200 patients who were due for seasonal flu shots and had not yet had them. The clinic then contacted the patients to tell them to come in for their vaccinations.

Veterinarians have used their own version of such a system for years to remind pet owners to come in for shots but the incentive has not been there for medical doctors.

Now, however, the province is offering a carrot to doctors in the form of a $28,000 grant over three years to adopt a system of electronic record keeping. It's being made available through eHealth, in conjunction with OntarioMD, a subsidiary of the Ontario Medical Association.

According to the OMA, physicians are showing keen interest. In one recent week alone, OntarioMD received more than 650 inquiries.

OntarioMD chair Dr. Stephen Chris acknowledges there is more enthusiasm for the product among younger and more computer-savvy doctors. "There is probably a generational impact on adoption. Having said that, I know some physicians in their early 60s who are putting in electronic medical records because they know they can't attract younger doctors without it."

Law says electronic medical records help cut down on human errors caused, for example, by messy handwriting or lost pieces of paper.

Treatment is provided faster because health care providers are not waiting for referrals or tests results to come through the mail.

With up-to-date medication histories, patient safety is improved. For example, if a patient is allergic to penicillin, an alert will flash on the computer screen if the drug is ordered.

Devitt says the benefits of electronic medical records in doctors' offices is the "tip of the iceberg" when it comes to advantages that electronic records have to offer.

"The eHealth plan for Ontario is much more than just EMRs (electronic medical records) in physicians' offices. It's digital X-rays ... It's lab results. It's drugs," he says.

For example, an x-ray or MRI image taken at a hospital can be called up on a computer at a specialist's office without films having to be physically transferred. Prescriptions or blood tests done at a lab can be sent by computer, not mail.

"Think of all the value that this can offer physicians and patients," Devitt says, when doctors no longer have to rifle through ever-expanding piles of paper.

As for the old paper files, eHealth's interim chair says: "In the fullness of time, we will be rid of them."

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